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Our user asked: "Good Evening I had a knee injury and had surgery and in the end I ended up with little to no cartlidge left under my knee and I need more surgery to fix that but for right now I am trying to put that off. When I walk and when I exercise on an eliptical machine the foot on my injured knee leg turns outward. I try to straighten it so that it faces forward and that causes more knee pain. It seems to be less painful with my foot out. Is there anything I can do to correct this? Are there certain muscles I should work on? Thank you for your time."
Ask a PT Response: "It is not uncommon based on seeing patients with similiar conditions as yours for the patient to externally rotate the involved lower extremity so that the foot is everted out. They perform this action because this position allows for the greatest comfort when arthritis has claimed the articular cartilage (cartilage acts as a cushion between joints) at the femoral and tibial condyles. Often times when arthritis at the medial aspect or inside knee is greater than the arthritis at the lateral aspect or outside knee, the patient will position the leg and foot out in order to obtain the greatest cushion and achieve the greatest comfort. However, there could be other reasons for this positioning as well such as leg length discrepancy, decrease flexibility, weakness, etc..
In regards to your question, is there anything you can do to correct this, it will depend on how much degenerative changes have occured at your knee. Since you mention that your knee is pretty much bone on bone with minimal cartilage, I would anticipate that you would have a very difficult time with correcting your positioning given my above reason. Patients with this condition should continue to work on increasing or maintaining strength, ROM and flexibility. Low impact exercises along with exercises in the pool are often recommended as well. I hope this helps."
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